Detection, frequency and prediction of problems in the use of the proseal laryngeal mask airway in children

Sanders, John C.; Olomu, Patrick; Furman, Joseph R.

doi:10.1111/j.1460-9592.2008.02784.x

Cited by 15 publications

(7 citation statements)

References 24 publications

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“…These tidal volumes will be used to calculate the maximum minute volume. If the maximum minute ventilation is at least 12 l/min for adults or weight adapted for children (considering at least double the respiratory minute volume at normoventilation), it can be assumed that the SGA can be safely used also during the increased demands regarding the ventilation during advanced indications [24,25]. As well as the PLMA and LMA Supreme (Teleflex Medical, Athlone Co., Westmeath, Ireland), other versions are increasingly being used.…”

Section: Maximum Minute Ventilation Testmentioning

confidence: 99%

Laryngeal mask airway indications

Timmermann

Bergner

Russo

2015

Current Opinion in Anaesthesiology

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Section: Maximum Minute Ventilation Testmentioning

confidence: 99%

Laryngeal mask airway indications

Timmermann

Bergner

Russo

2015

Current Opinion in Anaesthesiology

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“…The use of jaw thrust and/or partial cuff inflation have also given high success rates (39). Clinical tests of malposition described for adults, such as depth of insertion, leak pressure and maximum minute ventilation to resting minute ventilation ratio (MMV/RMV) have also been verified in children (51). Gel displacement tests (47,52), bilateral chest movement and square wave capnography, all of which are very simple to perform, are also used to assess positioning in many studies (12,39,53) and by the authors of this article, in routine clinical practice.…”

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confidence: 99%

A critique of elective pediatric supraglottic airway devices

White

Cook

Stoddart

2009

Pediatric Anesthesia

102

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Summary In 1988, when the Laryngeal Mask Airway‐Classic™ (Intavent Orthofix, Maidenhead, UK), was introduced there were only two choices of airway management: tracheal tube or facemask. The supraglottic airway, as we now understand the term, did not exist. Yet, 20 years later, we are faced with an ever increasing choice of supraglottic airway devices (SAD). For many SADs, with the exception of the LMA‐ClassicTM and LMA‐ProsealTM (Intavent Orthofix, Maidenhead, UK), there is a lack of high quality data of efficacy. The best evidence requires a randomized controlled trial comparing a new device against an established alternative, properly powered to detect clinically relevant differences in clinically important outcomes. Such studies in children are very rare. Safety data is even harder to establish particularly for rare events such as aspiration. Therefore, most safety data comes from extended use rather than high quality evidence which inevitably biases against newer devices. For reason of these factors, claims of efficacy and particularly safety must be interpreted cautiously. This narrative review aims to present the evidence surrounding the use of currently available pediatric SADs in routine anesthetic practice.

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“…Its efficacy in providing good conditions for PPV has been demonstrated in children [22-24]. The improved seal, compared with the classic LMA, with pediatric sizes (1.5, 2, 2.5), which lack a dorsal cuff, is likely because of a better anatomic fit in the pharynx of the PLMA cuff compared with the classic LMA [25]. Hence, our study also used PLMA; in cases where e PLMA was safely placed in the supine position, it was observed that even with head rotating, the PLMA maintained a safe placement.…”

Section: Discussionmentioning

confidence: 99%

The effect of head rotation on efficiency of ventilation and cuff pressure using the PLMA in pediatric patients

Park

Han

2011

Korean J Anesthesiol

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BackgroundThis study examined whether changing the head position from neutral to side can affect expiratory tidal volume (TV) and cuff pressure when the appropriate sizes of a Proseal™ Laryngeal Mask Airway (PLMA)-depending on the body weight -are used in pediatric patients during pressure controlled ventilation (PCV).MethodsSeventy-seven children (5-30 kg) were divided into three groups according to their body weight, PLMA#1.5 (group I, n = 24), #2 (group II, n = 26), and #2.5 (group III, n = 27). After anesthesia induction, a PLMA was placed with a cuff-pressure of 60 cmH2O. The TV and existence of leakage at the peak inspiratory pressure (PIP) of 20 cmH2O, and the appropriate PIP for TV 10 ml/kg were examined. Upon head rotation to the left side, the TV, PIP, cuff pressure changes, and the appropriate PIP to achieve a TV 10 ml/kg were evaluated.ResultsHead rotation of 45 degrees to the left side during PCV caused a significant increase in cuff pressure and a decrease in TV, and there was no definite leakage. Changes in PIP and TV were similar in the three groups. The cuff pressure increased but there was no significant difference between the three groups.ConclusionsAlthough cuff pressure and TV of the PLMA were changed significantly after turning the head from the neutral position to the side, a re-adjustment of the cuff pressure and PIP to maintain a TV of 10 ml/kg can make the placed PLMA useful and successful in pediatric patients under general anesthesia.

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Detection, frequency and prediction of problems in the use of the proseal laryngeal mask airway in children

Abstract: The PLMA can be used in a large variety of cases with a high degree of success. Clinical tests described for adults, such as MMV/RMV ratio and DOI are also associated with complications in the pediatric population.

Cited by 15 publications

References 24 publications

Laryngeal mask airway indications

Laryngeal mask airway indications

A critique of elective pediatric supraglottic airway devices

The effect of head rotation on efficiency of ventilation and cuff pressure using the PLMA in pediatric patients

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